Persistent neurologic symptoms and cognitive dysfunction in non‐hospitalized Covid‐19 “long haulers”

Objective Most SARS‐CoV‐2‐infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non‐hospitalized Covid‐19 “long haulers”. Methods This is a prospective study of the first 100 consecutive pa...

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Bibliographic Details
Published in:	Annals of Clinical and Translational Neurology 2021-05, Vol.8 (5), p.1073-1085
Main Authors:	Graham, Edith L., Clark, Jeffrey R., Orban, Zachary S., Lim, Patrick H., Szymanski, April L., Taylor, Carolyn, DiBiase, Rebecca M., Jia, Dan Tong, Balabanov, Roumen, Ho, Sam U., Batra, Ayush, Liotta, Eric M., Koralnik, Igor J.
Format:	Article
Language:	eng
Subjects:	Adult Anxieties Cognition & reasoning Cognitive ability Cognitive Dysfunction - diagnosis Cognitive Dysfunction - etiology Coronaviruses COVID-19 COVID-19 - complications COVID-19 - diagnosis COVID-19 - etiology COVID-19 - psychology Demographics Disease Ethnicity Fatigue Fatigue - diagnosis Fatigue - etiology Fatigue - psychology Female Headache - diagnosis Headache - etiology Headache - psychology Hispanic Americans Hospitalization Humans Insomnia Laboratories Male Memory Middle Aged Nervous System Diseases - diagnosis Nervous System Diseases - etiology Nervous System Diseases - psychology Pandemics Patients Pneumonia Post-Acute COVID-19 Syndrome Prospective Studies Quality of life Serology Standard deviation Telemedicine - methods Telemedicine - trends
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Summary:	Objective Most SARS‐CoV‐2‐infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non‐hospitalized Covid‐19 “long haulers”. Methods This is a prospective study of the first 100 consecutive patients (50 SARS‐CoV‐2 laboratory‐positive (SARS‐CoV‐2+) and 50 laboratory‐negative (SARS‐CoV‐2‐) individuals) presenting to our Neuro‐Covid‐19 clinic between May and November 2020. Due to early pandemic testing limitations, patients were included if they met Infectious Diseases Society of America symptoms of Covid‐19, were never hospitalized for pneumonia or hypoxemia, and had neurologic symptoms lasting over 6 weeks. We recorded the frequency of neurologic symptoms and analyzed patient‐reported quality of life measures and standardized cognitive assessments. Results Mean age was 43.2 ± 11.3 years, 70% were female, and 48% were evaluated in televisits. The most frequent comorbidities were depression/anxiety (42%) and autoimmune disease (16%). The main neurologic manifestations were: “brain fog” (81%), headache (68%), numbness/tingling (60%), dysgeusia (59%), anosmia (55%), and myalgias (55%), with only anosmia being more frequent in SARS‐CoV‐2+ than SARS‐CoV‐2‐ patients (37/50 [74%] vs. 18/50 [36%]; p
ISSN:	2328-9503 2328-9503